Abstract

PIP: This brief case history documents the usefulness of administering prostaglandins (PGs) postpartum for treating uterine atony after cesarean section. The patient was a 29-year-old gravida 2, para 0. After cesarian section, the atony of the uterus was noted, and the patient did not respond to intravenous ergotrate or brisk uterine massage with warm sponges. PGF2 alpha was injected superficially into the myometrium; about 1 mg of a 5 mg/ml solution was administered. Uterine contraction began almost immediately. However it was limited to the local area of injection and sustained for less than 2 minutes. After 6 such injections failed to produce the desired effect, the patient was given 250 mcg of PGF2 alpha 15-methyl ester Tham salt intramuscularly. After 8 minutes, the uterus increased tone in a tetanic-like contraction which sustained. No further atony occurred. Nor did side effects present a problem. Estimated blood loss during this time was 850 ml, and the postoperative hemoglobin was 8.5 gm/100 ml.